The random bowl drawing to decide a pivotal seat in Virginia could have a huge impact on healthcare for 400,000 people

Republican David Yancey won a seat in the Virginia House of Delegates over Democrat Shelly Simonds after a random drawing out of a bowl on Thursday.

The drawing keeps the GOP in control of the House of Delegates, with a 51 to 49 majority.

Yancey’s victory makes the path to possible Medicaid expansion more difficult for Democrats in the state.

The composition of the Virginia House of Delegates, and possibly the future of thousands of Virginians’ healthcare, was determined by a random drawing out of a bowl on Thursday.

The drawing that made Republican David Yancey the winner of the House seat over Democrat Shelly Simonds will give the GOP a slight advantage in the Virginia legislature and could affect the future of the Medicaid program in the state.

Virginia has so far not expanded the Medicaid program under the Affordable Care Act, despite repeated attempts from former Democratic Gov. Terry McAuliffe. Expanding the program would allow people making up to 138% of the federal poverty line to receive healthcare coverage through Medicaid, which could total as many as 400,000 Virginians.

Simonds is considering challenging the election results further. But if Yancey does indeed take the seat and Republicans come in control of both chambers of the legislature, expanding the program would become more difficult.

Expanding the program could still be possible under a Republican-controlled legislature, which had been expected before Democrats’ wave of victories in the state in November. Northam has expressed interest in working on a bipartisan solution to expansion, and only a few Republican members would need to reach across the aisle to get it done.